Organization Active NPI

Covenant Village Opco LLC

Doing business as Covenant Village Care Center

  • Skilled Nursing Facility
  • Cincinnati, OH
National Provider Identifier
1902694722
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COVENANT VILLAGE OPCO LLC
Doing business as
Covenant Village Care Center
Practice address
3210 W Fork Rd
Cincinnati, OH 45211-1948
Phone
(330) 620-7828
NPI assigned
Apr 30, 2025
Last updated
Dec 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeffrey Degyansky
Title
Chief Operating Officer
Phone
(330) 620-7828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3210 W Fork Rd
Cincinnati, OH 45211-1948

Mailing address

5910 Landerbrook Dr Ste 150
Mayfield Heights, OH 44124-6506

Other names 1

  • Covenant Village Care Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1902694722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 LANDERBROOK DR STE 150",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441246506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 W FORK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452111948",
            "telephone_number": "330-620-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT VILLAGE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-30",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "DEGYANSKY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "330-620-7828"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Village Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.